Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective　To analyze the influencing factors of early neurological deterioration in acute cerebral infarction patients with middle cerebral artery (MCA) occlusion.Methods　One hundred and thirty-four acute cerebral infarction patients with MCA occlusion in the department of neurology of our hospital from January 2017 to December 2019 were enrolled retrospectively.The definition of early neurological deterioration (END) was the national institutes of health stroke scale (NIHSS) score increased by ≥ 2 compared with the baseline NIHSS score of admission within 72 hours.Forty-eight cases in END group and 86 cases in non-END group.Baseline and clinical data at admission were compared between the two groups.Binary multivariate logistic regression analysis were used to assess the influencing factors of END in acute cerebral infarction patients with MCA occlusion.Results　(1)Gender,age,time of onset,admission NIHSS score,collateral circulation and parameters of blood pressure variability (SBPsd,SBPcv,SBPmax-min,DBPsd,DBPcv,DBPmax-min) were statistically significant between non-END group and END group.(2)Multivariate logistic regression analysis suggested that poor collateral circulation(OR=8.330，95%CI 1.629~42.587,P=0.011) and SBPmax-min (OR=1.139,95%CI 1.032~1.258,P=0.01) were independent risk factors for END in acute cerebral infarction patients with MCA occlusion.SBPmax-min predicted effectively END with best cutoff value 35.5,sensitivity 93.8%,specificity 64% and AUC0.85 (95%CI 0.788~0.912,P<0.001).Conclusion　There were many factors affecting END in patients with acute cerebral infarction with MCA occlusion.Poor collateral circulation and Blood pressure variability (BPV) were independent risk factors for END.

Objective To study the effect of tripterysium glycosides tablets on the pharmacokinetics of valsartan in rats combined with tripterysium glycosides tablets and valsartan. Methods 16 male Sprague-Dawley rats were randomly divided into two groups: the single administration group and the combined administration group. In the single administration group, the rats were given intragastric administration of valsartan (20 mg/kg) and the combined administered group was given intragastric administration of tripterysium glycosides tablets (10 mg/kg) and valsartan (20 mg/kg). Blood samples were taken at different time points and plasma concentrations of valsartan were determined by LC-MS. Pharma-cokinetic parameters were calculated. Results The maximum plasma concentration of valsartan was [(1. 57 ±0. 32) vs(1. 01±0. 28)μg/mL] and the plasma area under the curve was [(10. 01 ±0. 58) vs (6. 82±0. 77)mg·h/L], which were signifi- cantly increased in the combined administration group combined with the single administration group (P＜0. 05), indicating that valsartan metabolism was significantly inhibited. Conclusion Tripterysium glycosides tablets combined with valsartan has a significant effect on the pharmacokinetics of valsartan. This study plays a guiding role in the combined administration of valsartan and tripterygium glycosides tablets, which can avoid the occurrence of clinical adverse drug interactions.

OBJECTIVETo review the influencing factors of the early complication after carotid endarterectomy (CEA).

METHODSRetrospective analysis of clinical data of 509 cases received CEA in Xuan Wu Hospital of Capital Medical University, Liaocheng People's Hospital and Dalian Central Hospital from January 2001 to December 2011. There are 422 male patients and 72 female patients among the 494 patients, 15 patients underwent CEA by stages. The patients were between 35-84 years old,and the mean age was (64 ± 9) years. The complications within 30 days after CEA were analyzed, and find the risk factors for the major adverse events. Chi-square analysis was performed to analyze the correlation between the each variable of the basic characteristics of population, clinical features and intraoperative data and early adverse events after CEA. Logistic regression analysis was used to assess the relationship between a variety of factors and the postoperative complications within 30 days.

RESULTSTechnical complete rate of 98.6%, 7 cases of near-total occlusion patients could not been recanalized. Major complications in 30 days after CEA occurred in 20 cases (3.9%), including 6 cases of deaths (1.2%), 9 cases of cerebral infarction (1.8%) and 5 cases of cerebral hemorrhage (1.0%). Secondary complications occurred in 120 cases (23.6%). Univariate analysis showed modified Rankin scale (mRS) ≥ 3 on the incidence of early postoperative complication had significantly difference (χ² =20.517, P < 0.01), multivariate logistic regression analysis revealed that smoking (OR=2.667, 95% CI: 1.048-6.791, P=0.040) and mRS ≥ 3 (OR=8.690, 95% CI: 3.279-23.031, P=0.000) were the significant predictors of 30 days of the end event.

CONCLUSIONThe complications after CEA are uncommon, the security is proved. Smoking and mRS ≥ 3 can increase the risk of CEA.

Adult ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; complications ; Endarterectomy, Carotid ; adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Smoking ; Time Factors ; Treatment Outcome

Objective To investigate the effect of intervention management of hypertension and related risk factors.Methods One hundred and twenty hypertension patients are intervened in terms of blood uric acid,unbalanced diet,overweight,obesity,smoking,excessive drinking,stress and lack of physical activity.And after the medication,comparative analysis is carried out after 1 years follow-up supervision.Results There were significant differences in terms of systolic blood pressure,diastolic blood pressure,waist circumference,body mass index(BMI),fasting blood glucose,total cholesterol,low density lipoprotein (LDL),triglyceride (TG),high density lipoprotein (HDL),blood uric acid and halophilic,stroke like adaptation and cognitive ability in hypertension before and after intervention (t =10.44,8.93,3.98,2.76,7.82,5.39,3.11,3.88,2.24,2.73,5.31,5.11,6.44,3.60,6.58 respectively ;P ＜ 0.01).There weren't significant differences regarding of smoking habit,unregularly life style and stress (P ＞ 0.05).Conclusion The intervention on blood pressure and related risk factors based on changing lifestyles is proved to be with high efficiency in University Communities.

10 male subjects participated in the environmental simulation study to evaluate the operation ergonomics at high-temperature in the cockpit. Grip strength, perception, dexterity, reaction and intelligence were measured respectively during the tests at 40 degrees C and 45 degrees C, simulating the high-temperatures in a simulation cockpit chamber. Then the data obtained were compared to the combined index of heat stress (CIHS). The average values of each item of the subjects' performance at the two different temperatures are compared. The results indicated that CIHS exceeded the heat stress safety line after 45 min at 40 degrees C, grip strength decreased by 12%, and perception increased by 2.89 times. In contrast, at 45 degrees C, CIHS exceeded the safety line after 20 min, grip strength decreased by 3.2%, and perception increased by 4.36 times. However, Finger dexterity was less affected. Reaction ability was first accelerated, and then slowed down. The error rate in the intelligence test increased to a greater extent. At the high temperatures, the minimum perception was the most affected, followed by grip strength, reaction and finger dexterity were less affected, while the intelligence did not decline, but rise.
Adult ; Aerospace Medicine ; Aircraft ; Computer Simulation ; Ergonomics ; Heat Stress Disorders ; physiopathology ; Hot Temperature ; adverse effects ; Humans ; Male ; Young Adult

Objective To investigate the effects of early intensive therapy on P cell function and long-term glycemic control in newly diagnosed type 2 diabetic patients with different recruiting fasting plasma glucose (FPG) levels.Methods A total of 382 newly diagnosed type 2 diabetic patients with FPG 7.0-16.7 mmol/L were randomly assigned to therapy with insulin in the form of continuous subcutaneous insulin infusion (CSII) or multiple daily injection (MDI) or oral hypoglycemic agents (OHA, by using gliclazide and/or metformin) for initial rapid correction of hyperglycemia.The treatments were stopped after euglycemia had been maintained for 2 weeks.The patients were followed longitudinally on diet alone for 1 year.Intravenous glucose tolerances tests (IVCTTs) were performed and blood glucose, insulin and proinsulin were measured before and after therapy as well as at 1-year follow-up.Homeostasis model assessment ( HOMA) of β cell function and insulin resistance index ( HOMA-β and HOMA-IR ) were calculated.All the patients were stratified on the recruiting FPG: stratum A (7.0 mmol/L≤ FPG < 11.1 mmol/L) , stratum B (11.1 mmol/L≤ FPG ≤ 16.7 mmol/L).Results More patients in stratum A achieved target glycemic control (94.4% vs 89.8% ) and in shorter time [(5.9 ±3.8)d vs(6.9 ±3.6)d, P <0.05] as compared with those in stratum B.B cell function represented by HOMA-β and acute insulin response ( AIR) improved significantly after intensive interventions in both stratum A and B patients.However, the remission rate at 1 year was significantly higher in stratum A patients (47.8% ) than those in stratum B (35.7%, P < 0.05).The patients treated with insulin (especially with CSII) had higher remission rates and better improvement of AIR at 1 year follow-up irrespective of the recruiting FPG (CSII or MDI vs OHA: 57.1% , 51.8% vs 32.8% in stratum A, P <0.05; 44.4% , 38.7% vs 18.6% in stratum B, P <0.05).Conclusions Compared with OHA, early short time intensive insulin treatment had more favorable outcomes on maintaining AIR and prolonged glycemic remission in newly diagnosed type 2 diabetic patients irrespective of the recruiting FPG levels.

Objective On the basis of developing a new animal model for oxyhemoglobin (OxyHb) injection into subarachnoid space in mice, this research was to explore the temporal dependence and spatial distribution of OxyHb- induced apoptosis in the mouse brain cells in vivo and the mechanism of neurocyte injury induced by OxyHb. Methods The animal model for OxyHb injection into subarachnoid space in mice was developed. Mice were divided randomly into the experimental group (n=40) and the control group (n= 35). The control group received saline injection (50 μL ) and the experimental group received OxyHb injection (50 μL ), both into the subarachnoid space. The mice of the two groups were subdivided according to different postoperative time (3 h, 6 h, 12 h, 24 h and 48 h). The apoptosis or necrosis of cells was distinguished with microscopy (HE staining), transmission electron microscopy and TUNEL method. Results The distribution of apoptosis was mainly in the ipsilateral neocortex and bilateral hippocampal gyrus. The apoptotic mouse brain cells showed morphological changes in the experimental group by HE staining and transmission electron microscopy. The count of TUNEL-positive cells showed substantial increase in the experimental group, and there was a significant difference between the control and experimental groups, and the number of OxyHb- induced apoptotic cells decreased with time. Conclusion OxyHb in subarachnoid space in mice can induce apoptasis, but not necrosis of mouse brain cells in viro. The apoptotic brain cells show the pattern of temporal dependence and spatial distribution. It is suggested that the early treatment should be the method of first choice for treating the hemorrhagic brain injury.

OBJECTIVE To study characteristics of changing T lymphocytes in epidemic hemorrhagic fever(EHF) patients during acute phase and find out the pathogenesis,in order to elevate the level of early diagnosis.METHODS The anticoagulant blood from 30 cases of EHF patients and 50 normal healthy blood donors was collected.T lymphocyte subsets were detected by flow cytometry.RESULTS Compared with those of normal persons,CD4+ T cell counts of EHF patients decreased,CD8+T cell and double CD4+CD8+ cell(double positive cells,DP cell) counts of EHF patients increased obviously,and 25 cases of EHF in recovery stage returned to normal.And in comparison with HIV,CMV and EBV patients,DP cell counts of EHF patients increased obviously.CONCLUSIONS T lymphocytes of EHF decrease obviously but could be resumed,detection of amounts of lymphocyte subsets and CD4+CD8+ cells can provide an early diagnosis method to EHF.

Objective In order to provide important theoretical basis for further improving design of DC-7/7A high altitude partial pressure suit and FTF-2 air ventilation suit (named as A suit and B suit), the performance of ventilating heat dissipation of DC-7/7A and FTF-2 was studied. Methods Five healthy volunteers were enrolled to took participate in A group and B group tests. Environmental weather conditions for A and B suits were set at Tdb 40℃ and 45℃,rh 45% and 40% respectively, and the test time was 90min and 120 min respectively. Results During the test for A group and B group, Ts ranged from 31.5℃ to 34.5℃ for human comfort. Average skin temperatures of the lower part of the body were from 33.1℃ to 33.8℃. Skin temperatures of the legs did not obviously change or slightly lowered. Heart rate showed an increase of 12 beats/min and 14 beats/min. Sweat quantities were measured to be 0.288?0.056kg/1.5h and 0.445kg?0.077 kg/2h respectively. Evaporation rates were 77.4?3.6% and 84.2?2.4% respectively. Subjective uncomfortable sensation was more obvious as test time went on. Conclusion The results of the ventilating heat dissipation for both groups were quite good, but the findings suggested that the number of the ventilating holes for some important sites should shall be re-considered. Pilots wearing A group and B group with ventilation function would still suffer from mild heat stress and obvious subjective discomfort in hot enviroment.